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Office of the Press Secretary

For Immediate Release March 13, 1998
                            PRESS BRIEFING BY 
                             BARRY TOIV AND    
                             CHRIS JENNINGS,

The Briefing Room

1:42 P.M. EST

MR. TOIV: Before Mike comes out, why don't we have -- we are going to have Chris Jennings come to answer any questions you have about the health care event this afternoon. As you know, the President is receiving the report of the health care commission. We expect Mike down here pretty soon, though.

MR. JENNINGS: Good afternoon. I'm Chris Jennings, Deputy Assistant to the President for Health Policy. And I'm here to quickly brief you on the events this afternoon, and then any questions you may have.

The President is receiving the final report by the President's Advisory Commission on Consumer Protection and Quality. This is the report and it is available back there for any of you who are interested in it, as well as the Executive Summary. So you have plenty of paper to go through.

This commission has been one of the most successful commissions that any President has authorized. It was broadly based. It had representatives of businesses, of health plans, of consumers, of physicians, of medical ethicists, of state experts, and others, and they came, as you know, on November 20, and reported on the Consumer Bill of Rights, which the President immediately endorsed and called on the Congress to pass; he continues to call on the Congress to pass, and is encouraged by a lot of bipartisan legislation being developed as we speak.

Today's report is focusing on going beyond consumer protections to quality. And the best way to explain this, because it can be a little bit detailed and sometimes policy-wonkish, but it has a really significant potential to move beyond -- bring a new paradigm in terms of health care policy. And by that I mean, when we talk about consumer protections we're talking about assuring you have access to specialists, when you go into the emergency room you get your coverage, and if you want to have an appeals rights because you disagree with your health plan you get it. That's something that assures health care.

But what the report -- the commission is providing today is moving on beyond assuring to improving health care. And by that, they are reporting about the wide variety of problems that are currently in the health care systems in terms of under-utilization of services, in terms of over-utilization of services, in terms of just errors that actually decrease health care outcomes and increase costs. And what the recommendation of the commission is to build on a whole new system of development of standards that improve our ability to learn from the medical outcomes research that is now happening, where we can find what works for the treatment of a particular disease and a particular malady; make sure that the health plan covers it and informs their professionals, their health care professionals, within that health care plan to provide that level of treatment; and then, and most importantly, measure and provide that information to beneficiaries and enrollees around the countries so that when consumers are now choosing their health care plans, they're not just choosing on the basis of costs, they're not just choosing on the basis of what benefits are covering, they're choosing on the performance of their health plan, on the level of quality that their health plan is providing.

And that is a whole new system that has so much potential to not only decrease costs, because you're doing it right the first time, but also, of course, our number one priority is improve quality. And that's what this whole second report is. And you'll see that it's something that got a great deal of consensus; every single member of that commission endorsed the recommendations today and they are advocating for both legislation -- a combination of both a private sector approach and a public sector approach to begin to move towards having a national implementation of these recommendations.

First, they're recommending the development of a new council. That would probably require legislation. It would be represented by both the public and the private sectors. The council would study to make sure we are making progress in our interventions. And the second is a private forum which would have representatives of both the public and private sectors, but would actually develop new standards and distribute it and make it user-friendly and applicable to the health care delivery system.

It really is a very, very exciting time in health care because we now are using the science that is now becoming available to us to apply that science and that outcome to the health care services that we receive today.

The President today is going to move forward and say, fine, let's move ahead with this report. He's going to receive it, he's going to endorse it and, of course, applaud the commission for its fine work. And then he's going to endorse it and suggest that any type of legislation on Consumer Bill of Rights will incorporate the recommendation of the commission. He's also going to be releasing an executive order, executive memorandum which establishes immediately a new interagency task force which ensures that all the agencies within the federal government -- whether it be from VA, DOD, HHS, Labor, OPM which administers the federal health employees plan who are developing these standards -- interact with one another, develop standards collectively and collaboratively, and move towards having a more rational and much more successful quality implementation regime.

That is something the President is very, very pleased to be signing today. And the second order he is going to do is he's going to request and instruct the Vice President kick off this new forum that the commission is recommending by holding its first meeting probably here on the White House grounds, but certainly -- probably in Washington in June, so that we can start this private-public private forum that the commission is recommending.

That essentially is it. You will see the Vice President will be out there. The report was delivered to the Vice President yesterday. He will be submitting it to the President and the President will be receiving it and endorsing it. It will just be the Vice President and the President and it will be in the Rose Garden and should be a nice ceremony.

With that, I'll answer any questions you may have.

Q Is there some sentiment in the report that the President's proposal of a Patient's Bill of Rights is not necessarily a good thing?

MR. JENNINGS: No, not at all. In fact, the Consumer Bill of Rights that -- the Patient's Bill of Rights that the President has called on the Congress to pass is based on the recommendations that the commission made in November. In that report, they explicitly said that every health plan, every American should have that protection. What the President has said is if you're going to ensure that to be the case you're going to have to enact federal legislation to do that.

There are very few people who would suggest if you're going to provide and ensure that guarantee for all Americans that you could do it without federal legislation. But as you know, the commission chose not to decide how you should enforce these protections and they were operating on a pure consensus basis. I will say, of course, that the vast majority of every member of that commission would support -- not every member, but the vast majority of that commission, over three-fourths of them, would support federal legislation.

Q Would you explain -- a lot of Americans are not covered by health plans, but directly by self-insured plans run by their employers. Would what the President is proposing in terms of the Bill of Rights apply directly to companies that insure workers directly?

MR. JENNINGS: Absolutely. One of the problems with some of the states -- the states have passed a lot of laws in these areas; of course, not all states have. But they only apply to the insured plans, they don't apply to the self-insured plans. In fact, state laws don't apply to over 100 million Americans. You actually need to have federal legislation to take on the self-insured and the federally covered beneficiaries in this country.

Q So, just to follow up, companies wouldn't be required to offer health insurance or coverage to their workers, but if they offered it they would have to meet the standards --

MR. JENNINGS: Right. This is not a -- if you provide coverage, as the vast majority of employers do, you would ensure that their plans meet these standards.

And by the way, a lot of the business community, in terms of the actual protections themselves, are moving in that direction, too. They care about their employees, they're making progress in this area. But, of course, if you want to make sure that the public has the kind of confidence that we believe they are going to need to feel comfortable with this rapidly changing health care delivery system -- that they need to know that they have these consumer protections in place.

And then, secondly, they need to know that we are committed to improving the type of quality that we have in this health care delivery system through these recommendations that the commission is making today.

Q -- premiums go up to pay for the new rights --

MR. JENNINGS: Well, the Congressional Budget Office in their analysis of the President's budget took it upon themselves to do an analysis of what it would cost in terms of premiums for the President's Patient's Bill of Rights. They suggested it would cost about .75, less than one percent, and it would actually decrease over time to .3 percent. It's a very, very modest cost and certainly well worth the protection that these patient's rights would provide to all Americans.

Thank you all very much. Hope to see you in the Rose Garden.

Q They moved it to the East Room.

MR. JENNINGS: Oh, the East Room?

Q Yes, you don't want to be out there by yourself.

Q For people's health.

MR. JENNINGS: Oh. Well, I want you -- the President was concerned about you today. He thought it would be too cold, and so he suggested that we move it inside. I didn't know that that was going to happen.

Q A passionate President.

MR. TOIV: Since Mike isn't here yet, why don't we put the cart before the horse here and I'll do the week ahead.

Over the weekend, as you all know, the President and First Lady will be at Camp David. While they're resting there, the Vice President will be completing the efforts that the President has made this week to highlight the tobacco issue. He'll be up in Boston doing his fifth regional forum to discuss this issue, and he'll moderated a discussion there with young people and other guests about the most effective ways to discourage young people from smoking. And he'll show a number of anti-smoking ads, including a new ad with fashion model, Christi Turlington, who will also be present.

Q On Monday? What time?

MR. TOIV: No, that's on Saturday, in Boston.

Q Coverage?

MR. TOIV: Believe so. The V.P.'s Office will tell you that.

On Monday, the President will travel to Springbrook High School in Silver Spring, where he will meet with a number of state and local government officials, teachers and other education officials, to discussion the recent TIMSS test results, which, as you know, were not very favorable, for American students.

Q Will he embarrass the kids?

MR. TOIV: I'm not sure if these particular kids were among those tested. But he's going to talk about what steps the administration is taking --

Q What time, Barry?

MR. TOIV: That is going to be in the afternoon on Monday. No, I'm sorry, that's wrong -- it will be in the morning, about 10:30 a.m. He's going to meet -- they're going to have a roundtable. We'll have pool press at the top of the roundtable. Actually, among those attending that roundtable will be Governor Tom Underwood of West Virginia; Mayor Daley of Chicago; Mayor Reardon of L.A.; Mayor Lee Clancy of Cedar Rapids; and the President of the AFT, Sandy Feldman. And Bill Nye, the Science Guy, will also be there.

Q Will Christi Turlington be there? (Laughter.)

MR. TOIV: I think she'll still be in Boston.

Q Are these people being brought in for this event specifically by the White House, they don't happen to just be in town?

MR. TOIV: That's correct. That's correct.

Q Are they having their way paid by the taxpayers?

MR. TOIV: Don't know the answer to that one, Sam. We can check on that for you, though.

At that roundtable they're going to talk about what the state and local governments, as well as educators can do to improve the students' performance. And then the President will address the students and the community in the high school auditorium.

Q What time?

MR. TOIV: That will be immediately following. The speech is scheduled for 11:30 a.m., I believe. If you're looking for that exactly -- noon. Wrong again. That will be at noon.

Q You can make a mistake, too.

MR. TOIV: I've made two so far. And we're only on Monday.

That evening the President will attend a couple of DNC events.

Q Like fundraisers?

MR. TOIV: Yes, they would be, as a matter of fact. One is in a private residence. The first is a Democratic Business Council dinner at the -- I'm about to make another mistake -- at the Sheraton Carlton. That's the Democratic Business Council. And then a DNC dinner in a private residence.

Q That's when the Paula Jones news conference will be held --

MR. TOIV: Tuesday is St. Patrick's Day, and we'll have the traditional St. Patrick's Day here, at least as of right now. The President will meet in the morning with Prime Minister Bertie Ahern of Ireland. And the Prime Minister will then present the President with the traditional bowl of shamrocks. And the President will go to the Capitol for the annual St. Patrick's Day lunch in the Capitol. And that evening the President and First Lady will host the annual St. Patrick's Day reception here at the White House.

Q When does the President meet with Gerry Adams?

MR. TOIV: I don't know if that's the case. Why don't you ask Mike that question.

Wednesday, the 18th, the President will travel to Las Vegas, Nevada.

Q What time does he leave?

MR. TOIV: He leaves on Wednesday -- it's not that early, actually -- he leaves somewhere between 8:30 and 9:00 a.m. I think that's a little in flux. There may be a departure statement as well. You get back late. I don't think we'll know until closer to the day, when it happens.

Q And he's addressing the AFL-CIO?

Q You're scheduling a statement just in case he thinks of something to say, or you've got --

MR. TOIV: No, we have something in mind to say. But we may change our mind. (Laughter.)

The President in Las Vegas he will -- the President will visit the Carpenters Apprentice Training Facility, which is a training facility operated by the Carpenters Union. And he'll tour the facility and speak to workers there. His subject will be how his administration is working to help American workers achieve the American Dream -- in other words, the impact his agenda is having on America's workers and their families. And again, there probably be a late arrival home that evening.

Q Is there a fundraiser?

Q Is there no other event? AFL-CIO and then --

MR. TOIV: I think next week we'll be able to talk about that a little bit more.

Q So at the moment this is the only thing on his schedule in Las Vegas?

MR. TOIV: Well, no, there may be something else which I'm told that, for reasons unknown, that we're not prepared to announce yet. (Laughter.)

Q Negotiating the size of their contribution? (Laughter.)

Q -- the whole reason he's going out there, isn't it?

MR. TOIV: Call Scheduling.

Thursday, the President is looking forward to greeting King Hussein of Jordan here. They'll be meeting here to discuss Iraq and the Middle East peace process.

Q Time?

MR. TOIV: The time on that is 2:00 p.m.

Q And that's an official visit?

MR. TOIV: I believe that is a -- I don't know that it's classified that way. It's just a meeting. I don't know -- I'm not sure that it's even a working visit.

Q Is he going to get lunch, or dinner, or anything, right?

MR. TOIV: I don't think so. Afraid not.

Q Is the King here -- he's in Washington --

MR. TOIV: He apparently already -- as I understand it, he's already in town.

Q Oh, here comes your rescuer.

COLONEL CROWLEY: Long scheduled meeting.

Q You mean the King is here as we speak?

MR. TOIV: It's a long scheduled meeting. He's not at the White House, no, but he's in Washington -- apparently in Washington. Is that correct? I believe --

Q Is he having medical check-ups, that kind of thing?

MR. TOIV: The King has arrived -- well, he's in the U.S. -- maybe not in Washington.

Q Mayo Clinic or wherever he goes.

MR. TOIV: While he's in town, in addition to meeting with the President, he is going to meet with Secretary Albright, Secretary Cohen and members of Congress. Don't have the dates on those meetings, though.

Q Press availability?

MR. TOIV: At the top. No, I think that's TBD.

That evening, the President will attend an event for the DSCC, the Democratic Senate Campaign Committee.

Q Private home, Barry? It makes a difference on coverage, which is why we ask.

MR. TOIV: I understand. I believe it's not going to be in a private residence, but for some reason I've got TBD down here so maybe they haven't nailed it down. But it appears to be planned for somewhere other than a private residence.

Q Friday?

MR. TOIV: Friday. Friday evening the President is looking forward to hosting the National Newspaper Association in a reception here. Except for practically the entire invitation list, the event is closed press. (Laughter.)

And on Saturday the President will deliver the radio address live. And then he will address, live by satellite, conferences that are being held in 10 cities around the country by the Pew Foundation. As you'll recall, the Pew Foundation announced that they were going to conduct a dialogue among the American people on Social Security, and these are their kick-off events. It's called "Americans Discuss Social Security." The President is going to address them live by satellite on next Saturday.

Q What time?

MR. TOIV: Around noon.

Q Is that Friday event for the National Newspaper Association, as in NAA, or National Newspaper Publishers Association, as in NNPA?

MR. TOIV: National Newspaper Association.

THE PRESS: Thank you.

END 2:05 P.M. EST